Recognizing and properly treating concussions in athletes of all ages has moved to the forefront of media coverage in recent years. Considerable progress has been made in changing perceptions about concussions and getting parents and coaches to treat them very seriously. However, in many cases of mild concussions, it is still generally unclear when it is acceptable for individuals, including children, to return to normal cognitive and physical activity after the head injury.
Academic Environment Stressors may Reduce Concussed Brain’s Ability to Heal
According to a recent study conducted by the Concussion Clinic at Children’s Hospitals and Clinics of Minnesota, a child who sustains a concussion during the school year requires significantly more recovery time in comparison to a child who sustains a similar injury when school is out of session. Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study’s researchers, said, “We were surprised at the magnitude of the differences. We weren’t surprised that it was in that direction; just simply that the magnitude was what it was.”
Researchers focused on patients who were evaluated in the Concussion Clinic at Children’s from 2011-12. A total of 43 children who sustained concussions during the school year were compared to a group of 44 who were injured in the summer months. For the students who sustained a concussion in the summer, researchers found that an average of 35 days was needed for recovery. In comparison, children who sustained a concussion during the school year required an average of 72 days for recovery.
According to another similar study entitled, “Returning to Learning Following a Concussion,” post-concussive symptoms often linger or increase in severity without proper adjustments to a child’s learning environment and/or academic routine. Research suggests that normal academic demands and the busy school environment could be a barrier to recovery.
Recovery Time Comparisons Definitive across Age Groups Based on Cognitive Demands
For the Concussion Clinic at Children’s study, subjects were evaluated and treated after showing symptoms consistent with mild head trauma. Researchers separated the subjects, ages 7 and older, into two groups determined by whether they recovered from their concussions during the school year or summer months. The school year was defined traditionally running from September through May. The school group was also paired against the summer group by age and gender.
The average age of the children in the study at the time of injury was 14 years old, while the recovery time period was defined as the final visit date in the Concussion Clinic. However, Doss made a point to caution parents and kids that they aren’t completely free from danger once recovery is complete. He added, “It seems pretty clear in some of the guidelines that prior history of a concussion puts you at a higher risk for subsequent concussions.”
According to Doss’ Children’s study, there’s little quantitative support for the amount or duration of actual cognitive and physical rest required after a concussion as well as the time frame for children to safely return to normal daily activities without experiencing ongoing cognitive or physical deficits.
The “Returning to Learning” study defines cognitive rest as avoiding potential cognitive stressors, such as texting, video games, TV exposure and schoolwork. But, to date, there is no established research documenting the benefits or harm of these methods based on the persistence of head injury symptoms or the long-term outcome for the student following a concussion.
Despite the lack of research, Doss noted how families’ and academic institutions’ perceptions about concussions seem to be evolving and headed in the right direction.
References:
Brain Injury Association of American
